Beta
109383

Evaluation of Functional Therapy Vs Intermaxillary Fixation in Condylar Fracture Treatment

Article

Last updated: 22 Jan 2023

Subjects

-

Tags

Oral and Maxillofacial Surgery

Abstract

Purpose: To compare the outcomes after rigid intermaxillary fixation (IMF) versus functional therapy (FT) in patients with mandibular condylar fractures (CFs). Patients and Methods: A prospective comparative study with 3 follow-ups (FU) at 1, 3 and 6 months was undertaken in 2 groups, which exclusively privileged either surgical or conservative treatment due to different therapeutic agendas. Patients from Group1 (GI) received IMF for 10 days, followed by physiotherapy, whereas those in Group2 (GII) had undergone FT for 21 days via guiding elastics. In both groups, all concomitant fractures (if present) were treated by open reduction and internal fixation (ORIF). Patients with unilateral CFs, with or without concomitant mandibular fractures showing one or more of the following conditions were included: adult patients (>18 years of age) indicated for closed treatment, and sufficient dentition for arch bars application. Previous history of tempromandibular joint (TMJ) dysfunction, severe pre-traumatic skeletal dysgnathia, and mid face fractures was excluded. Results: 12 patients (6 in GI and 6 in GII) were included. The clinical TMJ Dysfunction Index of Helkimo (CTDI-H) was equal in both groups at 1 month FU, it became worse in GI than in the GII at 3 month FU, corresponding to better function on the short-term. At the 6 month FU, there were better values in the GII. The Magnetic Resonance Imaging (MRI) scans revealed that the trauma caused disc displacement for 33.3% of GI and 66.7 % of GII. At 6 months FU, 33.3% of GI had improvement in the degree of the disc displacement, but they still had internal derangement with reduction. In GII, 2 out of 4 retained the normal position of the disc and the others had improvement in the disc displacement degree only. Conclusion: Both treatment options may yield acceptable results, however, FT seems to be the appropriate treatment for rapid recovery of range of mandibular motion (ROMM), relief of pain during palpation of masticatory muscles, and recovery of disc position during FU. Its success depends on the passive maneuver of physiotherapy if there is no restricted maximum interincisal opening (MIO) and it should be in a forcible manner in case of restricted MIO.

DOI

10.21608/adjg.2018.109383

Keywords

Condylar fractures, Functional therapy, Intermaxillary Fixation, Clinical TMJ dysfunction index of Helkimo, Magnetic Resonance Imaging, Physiotherapy

Authors

First Name

Al-Shaimaa

Last Name

Abd El Aziem

MiddleName

E.

Affiliation

Dentist at Bab El-Sha'ria Hospital, Al Azhar University.

Email

-

City

-

Orcid

-

First Name

Nahed

Last Name

Adly

MiddleName

M.

Affiliation

Lecturer of Oral & Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al - Azhar University.

Email

-

City

-

Orcid

-

First Name

Youssef

Last Name

El-Mansi

MiddleName

A

Affiliation

Lieutenant Colonel, Ph.D.s Oral & Maxillofacial Surgery, Armed Forces Hospitals.

Email

-

City

-

Orcid

-

First Name

Ghada

Last Name

Khalifa

MiddleName

A.

Affiliation

Assistant Professor of Oral & Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al - Azhar University.

Email

ghaamin@ymail.com

City

-

Orcid

-

Volume

5

Article Issue

Supplement

Related Issue

16596

Issue Date

2018-10-01

Receive Date

2018-08-25

Publish Date

2018-10-01

Page Start

503

Page End

509

Print ISSN

2537-0308

Online ISSN

2537-0316

Link

https://adjg.journals.ekb.eg/article_109383.html

Detail API

https://adjg.journals.ekb.eg/service?article_code=109383

Order

12

Type

Original Article

Type Code

488

Publication Type

Journal

Publication Title

Al-Azhar Dental Journal for Girls

Publication Link

https://adjg.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023